妊娠期间的牙周疾病合并1型糖尿病。

Guthmiller J M, Hassebroek-Johnson J R, Weenig D R, Johnson G K, Kirchner H L, Kohout F J, Hunter S K

Department of Periodontics and Dows Institute for Dental Research, College of Dentistry, University of Iowa, Iowa City 52242, USA.

J Periodontol. 2001 Nov;72(11):1485-90. doi: 10.1902/jop.2001.72.11.1485.

BACKGROUND

Systemic disease and hormonal changes have been implicated as complicating factors for periodontal disease. Diabetes has been identified as a risk factor for periodontal disease, and diabetics can experience periodontal destruction at an earlier age than non-diabetic individuals. Increased hormone levels during pregnancy can contribute to increased gingival inflammation. The purpose of this study was to examine the association of type 1 diabetes mellitus (DM) on the periodontal status of pregnant women.

METHODS

Thirty-three (13 diabetic and 20 non-diabetic) subjects, 20 to 39 weeks gestation, participated in this study. The mean age of the diabetics and non-diabetics was 28.5 +/- 7.1 (SD) and 27.0 +/- 7.3 years, respectively. The following parameters were assessed at Ramfjord's reference teeth: plaque index (PI), gingival inflammation (GI), probing depth (PD), gingival margin (GM) location, and clinical attachment level (CAL).

RESULTS

Diabetic subjects had significantly (P<0.001) higher PI (1.48 +/- 0.69) and GI (1.77 +/- 0.44) scores than non-diabetics (PI = 0.63 +/- 0.38; GI = 0.93 +/- 0.48). Mean PD for diabetics (2.95 +/- 0.69 mm) was significantly different (P<0.024) from that of non-diabetics (2.44 +/- 0.32 mm). Although mean GM location was coronal to the cemento-enamel junction (CEJ) in both groups, gingival margins were at a more apical position (P<0.001) in the diabetics (-0.20 +/- 1.24 mm) compared to non-diabetics (-1.76 +/- 0.53 mm). Mean CAL values also varied significantly (P<0.001) between diabetics (2.60 +/- 1.54 mm) and non-diabetics (0.68 +/- 0.65 mm). Significant differences were seen for GI (P<0.001), PD (P=0.005), GM location (P<0.001), and CAL (P<0.001) when assessing the effect of diabetes and controlling for plaque. When assessing the effect of plaque and controlling for diabetes, the only significant difference was GI (P=0.001).

CONCLUSIONS

The results of this study demonstrate that periodontal inflammation and destruction are increased in pregnant diabetics as compared to non-diabetic pregnant patients. These findings may have implications for diabetic control and, hence, maternal and fetal outcomes in pregnant diabetic patients.

背景

全身性疾病和激素变化被认为是牙周疾病的复杂因素。糖尿病已被确定为牙周疾病的一个风险因素，糖尿病患者比非糖尿病个体在更早的年龄就可能出现牙周组织破坏。孕期激素水平升高会导致牙龈炎症加剧。本研究的目的是探讨1型糖尿病（DM）与孕妇牙周状况之间的关联。

方法

33名妊娠20至39周的受试者（13名糖尿病患者和20名非糖尿病患者）参与了本研究。糖尿病患者和非糖尿病患者的平均年龄分别为28.5±7.1（标准差）岁和27.0±7.3岁。在Ramfjord参考牙上评估以下参数：菌斑指数（PI）、牙龈炎症（GI）、探诊深度（PD）、牙龈边缘（GM）位置和临床附着水平（CAL）。

结果

糖尿病患者的PI（1.48±0.69）和GI（1.77±0.44）评分显著高于非糖尿病患者（PI = 0.63±0.38；GI = 0.93±0.48）（P<0.001）。糖尿病患者的平均PD（2.95±0.69mm）与非糖尿病患者（2.44±0.32mm）有显著差异（P<0.024）。尽管两组的平均GM位置均位于牙骨质-釉质界（CEJ）的冠方，但糖尿病患者的牙龈边缘位置更靠近根尖（-0.20±1.24mm），与非糖尿病患者（-1.76±0.53mm）相比有显著差异（P<0.001）。糖尿病患者（2.60±1.54mm）和非糖尿病患者（0.68±0.65mm）的平均CAL值也有显著差异（P<0.001）。在评估糖尿病的影响并控制菌斑时，GI（P<0.001）、PD（P = 0.005）、GM位置（P<0.001）和CAL（P<0.001）存在显著差异。在评估菌斑的影响并控制糖尿病时，唯一的显著差异是GI（P = 0.001）。